Study links depression, suicide and seizures
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Results of a study hint that the brain dysfunction that underlies epilepsy may also determine whether people are at risk for suicide. In a large study conducted in Iceland, researchers found that attempted suicide and depression are each independently associated with an increased risk of seizures.
Although a link between Depression and suicide and seizures has been previously documented, most studies did not address the time order of the association. Up until now it was assumed that suicide attempts occurred more often in patients with epilepsy because the disease increases the risk for Depression.
To further evaluate this relationship, Dr. Dale C. Hesdorffer, from Columbia University in New York, and colleagues identified 324 individuals ages 10 years or older with unprovoked seizures or epilepsy first diagnosed between 1995 and 1999 and matched them by age and gender with 647 subjects drawn from an Icelandic population registry.
They used standardized interviews to gauge symptoms of major depression and “suicidality” that were present before the date of the first seizures.
In the Annals of Neurology, Hesdorffer and colleagues report that a history of major depression increased the risk of epilepsy. Moreover, people with epilepsy were four times more likely to have attempted suicide before ever having a seizure, even after other factors were taken into account linking drinking alcohol, having depression, age, and gender.
These data suggest that the brain dysfunction that underlies epilepsy may also increase the risk of suicide. The results also suggest that depression and suicidal behavior may be related to different mechanisms.
Summing up, the researchers suggest that patients presenting with a new unprovoked seizure “should be evaluated for a history of suicide attempt and major depression. This history may be useful in directing choice of treatment and efforts to prevent later completed suicide.”
SOURCE: Annals of Neurology October, 2005.
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